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目的:分析胎盘早剥漏诊、误诊原因,提高早期确诊率,降低母儿并发症。方法:回顾性分析我院10年内胎盘早剥患者的临床资料,分析比较胎盘早剥漏诊与误诊原因。结果:过去十年内我院共检测出胎盘早剥86例,发生率为0.46%,该类孕妇临床表现主要为腰腹胀或腹痛、阴道流血、血性羊水。其中,急诊入院患者占(61.6%),有明确诱因39例,占45.3%,且以妊娠期高血压疾病、胎膜早破、外伤性因素为主。B超检出率62.8%。轻型胎盘早剥45例(52.3%),重型胎盘早剥41例(47.7%),出现症状到就诊及处理时间重型胎盘早剥均长于轻型胎盘组P<0.01。剖宫产分娩60例(69.8%),阴道分娩26例(30.2%)。结论:临床发病到临床处理时间是影响胎盘早剥轻重程度的重要因素;胎盘早剥临床表现易与早产、先兆临产或胎儿窘迫等混淆;后壁胎盘发生胎盘早剥时,超声容易漏诊。
OBJECTIVE: To analyze the causes of misdiagnosis and misdiagnosis of placental abruption, improve the early diagnosis rate and reduce the complications of maternal and child. Methods: The clinical data of patients with placental abruption within 10 years in our hospital were analyzed retrospectively. The causes of misdiagnosis and misdiagnosis of placental abruption were analyzed. Results: In the past ten years, 86 cases of placental abruption were detected in our hospital, the incidence was 0.46%. The main clinical manifestations of such pregnant women were bloating or abdominal pain, vaginal bleeding and bloody amniotic fluid. Among them, emergency admission patients accounted for (61.6%), 39 cases of clear incentives, accounting for 45.3%, and to hypertensive disorders of pregnancy, premature rupture of membranes, traumatic factors. B-detection rate of 62.8%. Forty-five cases (52.3%) had mild placental abruption, 41 cases (47.7%) had severe placental abruption, and the symptoms and the time of treatment and treatment of severe placental abruption were longer than those of the mild placenta group (P <0.01). Cesarean delivery in 60 cases (69.8%), vaginal delivery in 26 cases (30.2%). Conclusion: Clinical morbidity to clinical treatment time is an important factor affecting the severity of placental abruption. The clinical manifestations of placental abruption are easily confused with preterm birth, threatened labor or fetal distress. When placental abruption occurs in posterior wall placenta, ultrasound is easily missed.